Questions about detecting bone metastasis??

Faye33

I just had an appointment with my family doctor today concerning some hip/thigh bone pain I've been having for the past couple of months.  My oncologist advised I go see my family doctor when I called him and described the pain I was experiencing (a consistent deep dull ache which radiates from my hip and down my thigh and feels like it is in the bone).  He said it needed to be investigated.

My family doctor did an xray, which he read as all clear (the radiologist needs to look at it yet) and some blood work which I should be getting the results on tomorrow.

He is testing the blood work for increased protein levels which he said would be present if there were bone mets or liver mets.

Do protein levels always elevate with bone metastasis?

He showed me the xrays of my hip/thigh bone and there was something that concerned me.  I saw a cluster of white dots on my femur that reminded me of the microcalcifications (which turned out to be invasive cancer) I saw on my mammogram when I was diagnosed with breast cancer.  Is this something of concern or should I let it go? 

Also, is an x ray effective in picking up early bone mets?

He did mention pursuing further testing (MRI) if he can't find another explanation for my pain.  The pain isn't horrible... just there and has slowly gotten worse over the past couple of months.

Any insight is appreciated!  Thanks!

Naniam

Heather,  I had no pain whatsoever when my extensive bone mets was discovered about a month ago.  My blood work at that time was also still in normal limits.  I would never try to read an xray as I know I would see things even if the doctor told me all was ok.  I can share that my chest xray never picked up the mets that was in my sternum or ribs, so if the blood work is normal and you haven't had any relief from the pain, see if your doctor suggest additional testing. Perhaps a bone scan.   Do you have back problems?  This is the type pain both my husband and I had with back issues when the nerve is irritated.  

Hoping you get some relief and a simple reason and fix for the pain.   

Cynthia1962

Heather - I was dx'd with bone mets in my hip about a yr ago.  First, my tumor markers rose, then my onc sent me for a bone scan which showed the mets.  I also had an xray, which did not show the mets because it will only pick it up when the damage is more obvious.  I was having very little pain at this time and it just felt like there was a twinge in my hip. I didn't suspect a thing, actually. 

So, to answer you question, an xray is not a reliable way to pick up early mets.  My onc uses bone scans (for me), but I know it depends on what he feels is best for each woman's situation.   I have never heard of early bone mets increasing one's protein levels, but that doesn't mean I didn't miss that.  All my blood levels are normal except when my tumor markers go up in response to progression. 

I'm sure there will be others who will answer your post with better information.  Try not to worry.  There are a lot of things that can cause us to ache.  I hope you get some answers soon!

Leah_S

Heather, there are a lot of things that can cause bone pain, especially in the hip. I'm glad your doc is taking this seriously. The MRI is a good idea, since it should give a better idea of what's going on.

I very much hope what you're experiencing isn't mets.

All the best.

Leah

ck55

Cynthia, If you don't mind me asking, which of your markers was elevated and by how much?



My last blood work in Sept showed that my CA26-29 (?) was up to 40.5. It usually runs anywhere from 29 to 37, so it wasn't a huge jump but it still is outside the normal range. Naturally it freaked me out a bit!



Thanks, Cyndi

Faye33

Thanks all for your comments!  I heard from my docs office this morning and my bloodwork was good.  But my doctor likes to err on the side of caution, so I will be scheduleing my first ever bone scan per his recommendation.

I'm trying not to be worried because I know that there are so many other things which are not cancer related that could be causing the pain, but when you're blindsided by a cancer diagnosis at the age of 33, it's hard not to think worse case scenario when you have an ache or pain that won't go away.  A cancer diagnosis can turn even the most logical and level headed person into a hypochondriac for brief periods of time.

Breath in, breath out... a day at a time... life goes on!

bevin

Dear Heather,

I had similar pain prior to my cancer diagnosis. The pain was deep in the bone. It started out mild and got worse over time. It felt by the end that my hip was broken, the pain radiated to my thigh. I had an MRI and it turned out I had a L4L5 disc herniation that was impacting and compressing the nerve. They did nerve decompression and trimmed the herniation and my pain is gone.

Please make sure they also do an MRI of the lumbar area.  If your family doctor is of no help, see a neurologist or orthopedic surgeon. Your pain sounds very similar to mine. Lucky mine was prior to my BC else I'd had thought it was bone mets too.

Good you're being checked w a PET, but that won't show any herniation issues or compressed nerves in spine. If PET is clear please see the docs mentioned above. They are used to seeing patients with this pain w similar pathologys and causes.

Good luck.I hope everything on PET is NED

Cynthia1962

Heather - glad to hear that your blood work was normal.  It finally occurred to me that the increased protein levels you mentioned are tumor markers.  I'm so used to referring to them as tumor markers that I forget exactly what is being measured.  I'm glad your dr is going to order a bone scan for you.  It can't hurt and it'll give you piece of mind to know for sure.  Most likely, it's not mets. 

Cyndi - I replied to your PM (finally, lol).   

debbie6122

Heather- I had severe hip pain in my femur and radiated down my leg as well, this had been going on for at least 5 months, onco ordered an xray and he said it did not show any red flags, when i went to pick up a copy of my test a nurse brought up the xray on the computer for me to look at, it show white clusters like you mentioned i asked about these and he said it was most likely calcuim deposits. Was also told it was probably osteoporisis or low bone density. Hope that is all what is going on with you, keeping my fingers crossed for b9 results.